Adult Orthodontics

Clear Fixed Appliances

Fixed appliance attachments (the brackets) can be made from tooth coloured ceramic materials in order to reduce their visual impact. Such appliances are commonly termed 'ceramic fixed appliances'. Conventional ceramic fixed appliances use small elastics to hold the wire into the bracket and self–ligating brackets use an integral clip mechanism that secures the wire into position. The small elastics used with conventional fixed appliances can discolour in–between visits particularly with foods containing bright colouring.

The wires used to align teeth are commonly termed 'archwires'. These are made of metal (stainless steel or nickel–titanium) materials. They can be covered with tooth coloured coatings to make them less obvious. However, these coatings do have a tendency to decay between visits and may slow tooth movement.

Self–Ligating Brackets (Damon, In–Ovation C)

Unlike conventional fixed appliances, self–ligating appliances utilise an integral clip mechanism within the bracket in order to secure the archwire. Manufacturers have claimed many advantages to using these mechanisms, however, few of these have been scientifically proven to this day. In our opinion the principal advantages of self–ligation include more secure attachment between the archwire and bracket, less discolouration of appliances in–between visits and greater efficiency in appliance adjustments.

Many types of self–ligating appliances are available but two that have dominated the market include the Damon appliance and the In–Ovation appliance. These differ in having a different clip mechanism to secure the archwire. To date, there is no scientific evidence that one type of appliance is better than the other..

The In–Ovation C Appliance pictured right.

Invisalign

Invisalign is a virtually invisible way to straighten teeth and improve the smile. It can be used for those conscious about the appearance of fixed appliances where simpler tooth movements are required. Invisalign uses a series of clear removable aligners that gradually move teeth to their desired position. A major advantage of Invisalign, apart from being almost invisible, is that the appliance can be removed for eating, tooth brushing and important social engagements.

Lingual (Invisible) Orthodontic Appliances

Lingual orthodontic appliances are an exciting way of improving the smile for those conscious about having visible fixed appliances. These appliances are virtuously invisible as they are attached to the back (lingual) surfaces of the teeth. They can be used to produce high quality results in cases requiring complex tooth movements where Invisalign would be unsuccessful. At the London Specialist Orthodontic Practice, we use the InCognito system which has the advantage of improved patient comfort, less speech interference and better quality results than other lingual systems as the appliance is fully customised to you.

The In–Cognito Appliance pictured right.

The In–Cognito Appliance in situ

Orthognathic Jaw Aligning Surgery

Orthognathic surgery is a form of surgery used to align malpositioned jaw bones. It can be used to reposition the upper and lower jaw bones for a number of reasons:

The cosmetic correction of lower jaw retrusion or protrusion

For the correction of asymmetry of the chin point

To improve chewing function where there is poor contact between the upper and lower teeth

To improve the contact between the lips

To improve the stability of orthodontic treatment

To help reduce a double chin due to lower jaw retrusion

To improve obstructive sleep apnoea and snoring problems

Orthognathic surgery is commonly undertaken in combination with orthodontic treatment. A phase of orthodontic treatment is necessary before surgery in order to place the teeth into the correct position with respect to the individual jaw bones such that when the jaw position has been corrected the teeth meet normally. This also helps to improve the stability of surgical results. A short phase of orthodontic treatment is often necessary following surgery in order to fine tune the biting relationship. At the London Specialist Orthodontic Practice we are highly skilled at performing this type of treatment. We work with a group of world class surgeons from UCLH NHS Foundation Trust, Great Ormond Street Hospital and the Royal National Throat, Nose and Ear Hospital in order to provide the highest quality of patient care. We are BUPA accredited.